Monitoring of BG antigenemia is a useful noninvasive method for early diagnosis of IFI in patients with acute leukemia.A robbery turns bad when the victim decides to chase the robber, but halfway during the chase, the victim dies of a heart attack. The time interval between onset of fever as first sign of IFI and BG antigenemia was significantly shorter than the time to diagnosis of IFI by clinical, microbiological, radiological, an/or histopathological criteria (P5O pg/mL were observed in only 2 patients, both of whom experience failure of antifungal therapy. Sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of 2 cnsecutive BG values >7 pg/mL for diagnosis of proven or probable IFI was 0.63 (95% confidence interval, 0.44-0.79), 0.96 (95% confidence interval, 0.89-0.98), 0.79 (95% confidence interval, 0.57-0.92), 0.91 (95% confidence inerval, 0.84-0.95), and 0.89, respectively. During 190 consecutive neutropenic episodes (median duration, 22 days range, 7-113 days) in 95 patients, 30 proven or probable IFIs (13 aspergillosis, 15 candidiasis, and 2 mixed IFIs) were diagnosed.
IFIs were classified according to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group.
BG antigenemia was measured by a colorimetric assay twice weekly in the absence of fever and daily in the presence of fever. The aim of the present prospective study was to evaluate the usefulness of monitoring BG in patients undergoing chemotherapy for acute leukemia. Recent studies have reported that detection of 1,3-ß-D-glucan (BG) antigenemia may be useful for diagnosis of IFI. Because early diagnosis of IFI is difficult, new noninvasive, culture-independent diagnostic tools are needed to improve clinical management.
Invasive fungal infections (IFIs) are life-threatening complications in neutropenic patients with hematological malignancies.
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